クラミジア感染の重症化リスクを予測するマーカーを特定(Study Looks for Markers That Predict Risk of Severe Chlamydia Infection)

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2025-08-12 ノースカロライナ州立大学 (NC State)

ノースカロライナ州立大学とノースカロライナ大学の研究で、クラミジア感染が子宮や子宮内膜へ進行するリスクを予測できるバイオマーカーが特定された。感染リスクの高い女性246人の子宮頸部・膣のマイクロバイオームを解析した結果、Haemophilus haemolyticus、Sutterella stercoricanis、Actinobaculum massilienseなど特定菌種の多さが上行性感染と強く関連し、7種類のサイトカインレベルとも相関していた。さらにクラミジア量自体が上行性の強力な予測因子であることも判明。これらの知見は侵襲的検査なしで重症化リスクを判定できる診断法開発につながる可能性がある。

<関連情報>

子宮頸部・膣部の微生物学的特徴は、感染した女性の生殖器上部へのクラミジア・トラコマティス感染の拡散を予測する Cervicovaginal microbial features predict Chlamydia trachomatis spread to the upper genital tract of infected women

Sangmi Jeong, Tammy Tollison, Hayden Brochu, Hsuan Chou, Ian Huntress, Kacy S. Yount, Xiaojing Zheng, Toni Darville, Catherine M. O’Connell, Xinxia Peng
Infection and Immunity  Published:12 August 2025
DOI:https://doi.org/10.1128/iai.00057-25

クラミジア感染の重症化リスクを予測するマーカーを特定(Study Looks for Markers That Predict Risk of Severe Chlamydia Infection)

ABSTRACT

Chlamydia trachomatis (CT) infection can lead to pelvic inflammatory disease, infertility, and other reproductive sequelae when it ascends to the upper genital tract. Factors including chlamydial burden, coinfection with other sexually transmitted bacterial pathogens, and oral contraceptive use influence risk for upper genital tract spread. Cervicovaginal microbiome composition influences CT susceptibility, and we investigated if it contributes to spread by analyzing amplicon sequence variants (ASVs) derived from the V4 region of 16S rRNA genes in vaginal samples collected from women at high risk for CT infection and for whom endometrial infection had been determined. Participants were classified as CT negative (CT-, n = 70), CT positive at the cervix (Endo-, n = 79), or CT positive at both cervix and endometrium (Endo+, n = 68). Although we were unable to identify many significant differences between CT-infected and -uninfected women, differences in abundance of ASVs representing Lactobacillus iners and Lactobacillus crispatus subspecies but not dominant lactobacilli were detected. Thirteen informative ASVs predicted endometrial chlamydial infection (area under the curve = 0.72), with CT ASV abundance emerging as a key predictor. We also observed a positive correlation between levels of cervically secreted cytokines previously associated with CT ascension and abundance of the informative ASVs. Our findings suggest that vaginal microbial community members may influence chlamydial spread directly by nutrient limitation and/or disrupting endocervical epithelial integrity and indirectly by modulating proinflammatory signaling and/or homeostasis of adaptive immunity. Further investigation of these predictive microbial factors may lead to cervicovaginal microbiome biomarkers useful for identifying women at increased risk for disease.

医療・健康
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